Healthcare Provider Details

I. General information

NPI: 1205606829
Provider Name (Legal Business Name): ROBERT BROPHY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2024
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNITED STATES MILITARY
CAMP LEJEUNE NC
28542
US

IV. Provider business mailing address

PSC BOX 20138
CAMP LEJEUNE NC
28542-0138
US

V. Phone/Fax

Practice location:
  • Phone: 910-440-7372
  • Fax:
Mailing address:
  • Phone: 910-440-7372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1710I1002X
TaxonomyIndependent Duty Corpsman
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: